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TB patients in China often delay seeing a doctor for more than two weeks

People living with tuberculosis in China typically delay going to see a doctor for more than two weeks, according to a study recently published in BMC Medicine.

Shenglan Tang, a professor at Duke University, and Ying Li, a doctor from the Third Military Medical University, and their colleagues analyzed the behavior of close to 40,000 patients. The researchers found the patients who delayed going to see a doctor by more than two weeks were more likely to be less educated, live in rural areas or female. Patients cited lack of health insurance, poverty, rising costs of excess payments, treatments not covered by insurance and a poor understanding of TB as reasons for delay.

Patients would also try traditional Chinese medicine first, which was a risk factor for delay. Patients in rural areas were also subject to delays from limited resources at the healthcare facility, including an inability to do proper tests or a lack of qualified healthcare workers.

"Inadequate and late detection of TB remains a challenge especially in rural China," Tang and Li said. "By understanding the reasons behind this we can try to begin to change health intervention programs to ensure that these problems are addressed. There is also a stigma associated with TB which needs to be removed by better health promotion and by empowering individuals with TB to change how others view this disease."

TB is a leading cause of death worldwide, and China has the second largest TB epidemic and the most individuals infected with multi-drug-resistant TB. Delays in treatment can increase the risk of spreading TB. The delays can also contribute to the development of MDR-TB.